Schizophrenia Spectrum & Other Psychotic Disorders (Intro Psych Tutorial #234)

Summary

In this video, Michael Corayer reviews schizophrenia and related psychotic disorders from the DSM-5, focusing on the term's origin and its misconceptions. He explains the primary symptoms, including delusions, hallucinations, disorganized speech, and abnormal motor behaviors. The video also covers negative symptoms like emotional blunting and anhedonia. Diagnostic criteria require at least two positive symptoms over a month, with some symptoms present for six months. Cognitive deficits and brain differences in patients are discussed, along with the disorder's low prevalence and the common misconceptions about violence and aggression in patients.

Takeaways

• 😀 Schizophrenia is derived from the Greek words 'schizo' (split) and 'phren' (mind), indicating a split and disintegration of mental functions, not multiple personalities.
• 🤔 The main symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and abnormal motor behavior.
• 👁‍🗨 Delusions are false beliefs unsupported by evidence, such as persecution by government agencies or having supernatural powers.
• 👂 Hallucinations involve perceiving things that aren't present, like hearing voices or seeing non-existent objects.
• 🗣️ Disorganized speech in schizophrenia can be incoherent or described as 'word salad', making it hard to follow the patient's thoughts.
• 🤯 Negative symptoms of schizophrenia include blunted emotional expression, anhedonia (lack of pleasure), alogia (diminished speech), avolition (reduced will), and asociality (decreased social activity).
• 🏥 For a diagnosis of schizophrenia, patients must exhibit at least two positive symptoms, with one being delusions, hallucinations, or disorganized speech, over a month-long period.
• 🧠 Schizophrenia is associated with cognitive deficits in executive function, memory, attention, and a loss of contact with reality, known as psychosis.
• 🧬 Brain differences in schizophrenia patients include changes in cellular architecture, enlarged ventricles, and reduced gray matter volume, but these are not used for diagnosis.
• 🌐 Schizophrenia is a rare disorder, with a prevalence of about 0.3 to 0.7%, and it varies by sex, with males possibly being diagnosed more often due to differences in symptom expression.
• 🚫 Contrary to common misconceptions, individuals with schizophrenia are not typically violent; instead, they are more likely to be victims of violence or to self-harm, with a significant risk of suicide.

Q & A

What is the origin of the term 'schizophrenia'?

The term 'schizophrenia' originates from the Greek words 'schizo' meaning split and 'phren' or 'phrenos' meaning mind, and it was coined by Swiss psychiatrist Paul Eugen Bleuler.

What is the misconception associated with the term 'schizophrenia'?

A common misconception is that 'schizophrenia' refers to a split in personalities or identities, similar to dissociative identity disorder. However, it actually refers to a split and disintegration of mental functions and a separation from reality.

What are the main symptoms of schizophrenia?

The main symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and abnormal motor behavior.

Can you explain the difference between positive and negative symptoms in schizophrenia?

Positive symptoms are behaviors or experiences that are not typically present in healthy individuals, such as delusions and hallucinations. Negative symptoms are the absence or reduction of behaviors that are usually present, such as blunted emotional expression, anhedonia, alogia, avolition, and asociality.

What are the diagnostic criteria for schizophrenia according to the DSM-5?

To be diagnosed with schizophrenia, a patient must exhibit at least two of the positive symptoms (with one being delusions, hallucinations, or disorganized speech), and these symptoms must be present frequently over a one-month period with evidence of symptoms over six months.

How does the patient's insight into their condition affect the diagnosis of schizophrenia?

Patients with schizophrenia often lack insight into their condition, meaning they may not recognize their delusions or hallucinations as false. This can make self-reporting of symptoms unreliable, and diagnosis may require observation by others.

What cognitive aspects are commonly associated with schizophrenia?

Cognitive aspects associated with schizophrenia include deficits in executive function, memory, and attention, as well as a loss of contact with reality, also known as psychosis.

Can you describe catatonia as it relates to schizophrenia?

Catatonia in schizophrenia can manifest as abnormal motor behaviors, including locking the body into unusual postures, rigidity, or waxy flexibility where the patient allows themselves to be moved but does not self-initiate movement.

What brain differences are observed in patients with schizophrenia?

Brain differences in patients with schizophrenia compared to healthy individuals include changes in cellular architecture, connectivity of the white matter, enlargement of the ventricles, and reductions in gray matter volume.

What is the estimated prevalence of schizophrenia and how does it vary by sex?

The prevalence of schizophrenia is estimated to be about 0.3 to 0.7%, and it is more commonly diagnosed in males than females, possibly due to different expressions of the disorder or cultural interpretations of symptoms.

How does culture influence the expression and interpretation of schizophrenia symptoms?

Culture can influence the expression and interpretation of schizophrenia symptoms by shaping how certain behaviors, such as hearing voices or believing in persecution, are understood within a religious or societal context.

What is the relationship between schizophrenia and substance use disorders?

Schizophrenia is often comorbid with substance use disorders, but it's unclear whether substance use is a cause or consequence of the disorder. High rates of tobacco use among patients suggest it might be a form of self-medication.

What are common misconceptions about the behavior of individuals with schizophrenia?

A common misconception is that individuals with schizophrenia are violent or aggressive. In reality, they are more likely to be victims of violence and are at a higher risk of self-harm and suicide.